Melbourne School of Psychological Sciences - Research Publications

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    Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study
    Thompson, EJ ; Beauchamp, MH ; Darling, SJ ; Hearps, SJC ; Brown, A ; Charalambous, G ; Crossley, L ; Darby, D ; Dooley, JJ ; Greenham, M ; Jaimangal, M ; McDonald, S ; Muscara, F ; Turkstra, L ; Anderson, VA (BMJ PUBLISHING GROUP, 2018-05)
    BACKGROUND: Humans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS®), an iPad-based social skills assessment tool. METHODS: The PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children's Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0-17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants' social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q. ETHICS AND DISSEMINATION: Ethics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood Development (002318), and Catholic Education Melbourne (2166). Findings will be disseminated through international conferences and peer-reviewed journals. Following standardisation of PEERS®, the tool will be made commercially available.
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    Early predictors of psychosocial functioning 5 years after paediatric stroke
    Greenham, M ; Anderson, V ; Cooper, A ; Hearps, S ; Ditchfield, M ; Coleman, L ; Hunt, RW ; Mackay, MT ; Monagle, P ; Gordon, AL (WILEY, 2017-10)
    AIM: Little is known about psychological and social outcomes after paediatric stroke. This study aimed to evaluate psychosocial outcomes in children 5 years after paediatric stroke and explore the contribution of early presenting factors. METHOD: Thirty-one children (19 males, 12 females) with arterial ischemic stroke were involved in this prospective, longitudinal study. Children underwent intellectual assessment at 12 months poststroke and parents completed questionnaires rating their own mental health and their child's functioning at 12 months and 5 years poststroke. RESULTS: At 5-year follow-up, psychological and social function were significantly poorer than normative expectations. Exploration of early predictive factors showed poorer cognitive and psychological function at 12 months poststroke and older age at stroke onset was associated with poorer psychosocial function at 5 years. Larger lesion size was also associated with poorer psychological function at 5 years poststroke. INTERPRETATION: These early predictors of poorer psychosocial outcome suggest that screening children within the first year after stroke may identify children most at risk of later problems and facilitate early intervention.
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    Brain volumetric correlates of inhibition and cognitive flexibility 16 years following childhood traumatic brain injury
    Yu, K ; Seal, ML ; Reyes, J ; Godfrey, C ; Anderson, V ; Adamson, C ; Ryan, NP ; Hearps, SJC ; Catroppa, C (WILEY, 2018-04)
    Executive functions (EFs), such as inhibition and cognitive flexibility, are essential for everyday functioning, including regulation of socially appropriate emotional responses. These skills develop during childhood and continue maturing into early adulthood. The current study aimed to investigate the very long-term impact of childhood traumatic brain injury (TBI) on inhibition and cognitive flexibility, and to examine whether global white matter is associated with these abilities. Twenty-eight young adult survivors of childhood TBI (mean age at 16-year follow-up = 21.67 years, SD = 2.70) and 16 typically developing controls (TDCs), group-matched for age, sex, and socioeconomic status, completed tests of inhibition and cognitive flexibility and underwent structural MRI. Survivors of childhood TBI did not significantly differ from TDCs on EF or white matter volume. However, the relationship between EF and white matter volume differed between survivors of TBI and TDCs. Survivors of TBI did not mimic the brain behavior relationship that characterized EF in TDCs. The inverse brain behavior relationship, exhibited by childhood TBI survivors, suggests disruptions in the whole brain underpinning EF following childhood TBI.
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    Psychosocial, Demographic, and Illness-Related Factors Associated With Acute Traumatic Stress Responses in Parents of Children With a Serious Illness or Injury
    Muscara, F ; McCarthy, MC ; Thompson, EJ ; Heaney, C-M ; Hearps, SJC ; Rayner, M ; Burke, K ; Nicholson, JM ; Anderson, VA (WILEY, 2017-06)
    This study investigated factors associated with acute stress symptoms in parents of seriously ill children across a range of illnesses and treatment settings within a pediatric hospital setting. It was hypothesized that psychosocial variables would be more strongly associated with acute stress responses than demographic and child illness variables. Participants were 115 mothers and 56 fathers of children treated within the oncology, cardiology, and intensive care departments of a pediatric hospital. Acute stress, psychosocial, demographic, and medical data were collected within the first 4 weeks of the child's hospital admission. A robust hierarchical regression model revealed that psychosocial factors significantly explained 36.8% of the variance in parent acute stress responses (p < .001); demographic variables significantly added a further 4.5% (p = .022), but illness-related factors did not contribute to the model. Findings support the implementation of a general psychosocial screening approach for parents across the wider hospital system, and that psychosocial risk factors may be targeted in interventions across different illnesses and treatment settings to improve parent outcomes.
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    Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder - a systematic meta-analytic review
    Korrel, H ; Mueller, KL ; Silk, T ; Anderson, V ; Sciberras, E (WILEY, 2017-06)
    BACKGROUND: Children with Attention-Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non-ADHD controls. METHODS: A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non-ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t-Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta-analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p-curve techniques. RESULTS: Twenty-one studies were included in the systematic review (ADHD = 1,209; Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow-up meta-analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05; weighted mean ES [WMES]: 1.04); expressive (10/10 met p < .05; WMES: 1.23); receptive (12/14 met p < .05; WMES: 0.97), and pragmatic language (4/4 studies met p < .05; WMES: 0.98) compared with controls. CONCLUSIONS: This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.
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    Psychosocial function in the first year after childhood stroke
    Greenham, M ; Anderson, V ; Hearps, S ; Ditchfield, M ; Coleman, L ; Mackay, MT ; Monagle, P ; Gordon, AL (WILEY, 2017-10)
    AIM: Childhood stroke disrupts brain development and emerging neural networks. Motor, cognitive, and language deficits are well recognized, yet little is known about psychosocial function after childhood stroke. This study aims to describe psychosocial function within the first year after childhood stroke, and to identify factors associated with outcome. METHOD: Thirty-seven children were involved in a prospective, longitudinal study investigating recovery over the first year after childhood stroke. Children's social functioning was assessed at 6-months and 12-months poststroke and psychological function at 12-months poststroke, using standardized measures. RESULTS: Mean social function was poorer at both 6-months and 12-months poststroke, compared to prestroke. Psychological problems were more common than expected, with emotional difficulties and hyperactivity-inattention most significantly affected. Poorer social function was associated with older age at onset, acute neurological impairment, and prestroke social impairment. Social and psychological problems were associated with parent mental health. INTERPRETATION: While not all children are affected, psychosocial impairment affects a significant minority after childhood stroke. Older age at onset, acute neurological impairment, prestroke social problems, and poorer parent mental health were associated with deficits. Identifying early predictors of poorer outcome will facilitate early intervention. Of particular importance is parent mental health, suggesting support for families may improve child outcome.
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    The relationship between cognitive and neuroimaging outcomes in children treated for acute lymphoblastic leukemia with chemotherapy only: A systematic review
    Hearps, S ; Seal, M ; Anderson, V ; McCarthy, M ; Connellan, M ; Downie, P ; De Luca, C (WILEY, 2017-02)
    Cognitive late-effects have been identified in patients treated with chemotherapy-only protocols for childhood acute lymphoblastic leukemia (ALL), yet the underlying neuropathology is not well understood. This review synthesized recent findings from eight articles investigating the relationship between neurocognitive and neuroimaging outcomes for patients treated for ALL with chemotherapy-only protocols. Reported cognitive domains, imaging methods, and neuroanatomy examined were variable. Despite this, 62.5% (n = 5) of the reviewed studies found a significant relationship between cognitive and imaging outcomes. Greater understanding of the effects of treatment on neuroanatomy and cognitive outcomes is critical for proactively managing ALL cognitive late-effects. Research directions are suggested.
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    Health-related impairments in young children with ADHD: a community-based study
    Sciberras, E ; Bisset, M ; Hazell, P ; Nicholson, JM ; Anderson, V ; Lycett, K ; Jongeling, B ; Efron, D (WILEY, 2016-09)
    BACKGROUND: We aimed to examine health-related impairments in young children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls and explore differences in children with ADHD by gender, ADHD subtype and mental health co-morbidity status. METHODS: Children with ADHD (n = 177) and controls (n = 212) aged 6-8 years were recruited across 43 schools in Melbourne, Australia following a screening (Conners 3 ADHD Index) and case confirmation procedure (Diagnostic Interview Schedule for Children IV). Direct and blinded assessments of height and weight were used to calculate body mass index z-score and to identify overweight/obesity. Parents reported on child global health, sleep problems and physical injuries. Unadjusted and adjusted (socio-demographic factors and co-morbidities) logistic and linear regression were conducted to compare health-related impairments between (1) children with and without ADHD; (2) boys and girls with ADHD; (3) children with ADHD-inattentive and ADHD-combined types; and (4) children with ADHD by internalizing and externalizing disorder status. RESULTS: Children with ADHD had poorer global health than controls when adjusted for socio-demographic characteristics (OR: 2.0; 95% CI 1.1, 3.9); however, this attenuated after adjusting for co-morbidities. In adjusted analyses, children with ADHD had increased odds of moderate/large sleep problems (OR: 3.1; 95% CI 1.4, 6.8), compared with controls. There were no differences between children with and without ADHD in terms of physical injuries or overweight/obesity. Findings were similar when excluding children taking ADHD medication, and health-related impairments did not differ between boys and girls with ADHD. Children with ADHD-combined type had higher BMI z-scores than controls in adjusted analyses (P = 0.04). Children with ADHD and co-occurring internalizing and externalizing co-morbidities were particularly vulnerable to health-related impairments. CONCLUSION: Young children with ADHD experience a number of health-related impairments, which are exacerbated by the presence of internalizing and externalizing co-morbidities. Clinicians should consider the broader health of children with ADHD in clinical consultations.
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    Psychological trajectories of mothers and fathers following their child's diagnosis of a life-threatening illness or injury: A longitudinal investigation
    Darling, SJ ; Hearps, SJC ; Muscara, F ; McCarthy, M ; Nicholson, JM ; Burke, K ; Dimovski, A ; Anderson, V (WILEY, 2019-10)
    OBJECTIVE: Explore the mental health trajectories of parents following their child's life-threatening illness/injury. METHODS: Participants were 217 parents (mean age: 34.9-40.0; 66 fathers) of 165 children who presented to a tertiary hospital with a life-threatening illness/injury. Parents completed questionnaires about their mental health and psychosocial stressors within 4 weeks of the child's illness/injury (T1), and 4 months (T2), 7 months (T3), and 19 months (T4) postdiagnosis. RESULTS: For both mothers and fathers, mental health symptoms were elevated at diagnosis declining to normal levels by T3, with a pattern of increase at T4. Fathers demonstrated a faster decline in symptoms between T1 and T2, and fathers, but not mothers, experienced a relapse in depressive symptoms at T4. Fathers reported higher rates of work changes. CONCLUSIONS: These findings have important implications for the design and timing of parental interventions to support families of children with life-threatening disease/injury.
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    Motor function daily living skills 5 years after paediatric arterial ischaemic stroke: a prospective longitudinal study
    Cooper, AN ; Anderson, V ; Greenham, M ; Hearps, S ; Hunt, RW ; Mackay, MT ; Ditchfield, M ; Coleman, L ; Monagle, P ; Gordon, AL (WILEY, 2019-02)
    AIM: To describe 5-year motor and functional outcomes after paediatric arterial ischaemic stroke (AIS) and to explore factors associated with poorer long-term outcome. METHOD: Thirty-three children (21 males, 12 females) with AIS were recruited to a single-site, cross-sectional study, from a previously reported prospective longitudinal stroke outcome study. Children were stratified according to age at diagnosis: neonates (≤30d), preschool (>30d-5y), and school age (≥5y). Motor and functional outcomes were measured at 5 years after stroke. Neurological outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM) at 1 month and more than 4 years after stroke. RESULTS: At 5 years after stroke, motor function, quality of life, fatigue, adaptive behaviour, activities of daily living, and handwriting speed were significantly poorer than age expectations. The preschool group had the highest percentage of fine and gross motor impairment. Poorer fine motor skills were associated with subcortical-only lesions and large lesion size. Poorer gross motor outcomes correlated with preschool age, bilateral lesions, and PSOM impairment at 1 month. INTERPRETATION: Children are at elevated risk for motor and functional impairments after AIS, with the preschool age group most vulnerable. Identifying early predictors of poorer outcomes facilitates targeted early intervention and long-term rehabilitation. WHAT THIS PAPER ADDS: Following paediatric stroke, children are at elevated risk of motor and functional difficulties. Stroke occurring between 30 days and 5 years of age may result in poorer motor and functional outcomes.